Traffic-Related Air Pollution and Ground-Level Ozone Associated Global DNA Hypomethylation and Bulky DNA Adduct Formation.

Studies have indicated that air pollution, including surface-level ozone (O3), can significantly influence the risk of chronic diseases. To better understand the carcinogenic mechanisms of air pollutants and identify predictive disease biomarkers, we examined the association between traffic-related pollutants with DNA methylation alterations and bulky DNA adducts, two biomarkers of carcinogen exposure and cancer risk, in the peripheral blood of 140 volunteers-95 traffic police officers, and 45 unexposed subjects. The DNA methylation and adduct measurements were performed by bisulfite-PCR and pyrosequencing and 32P-postlabeling assay. Airborne levels of benzo(a)pyrene [B(a)P], carbon monoxide, and tropospheric O3 were determined by personal exposure biomonitoring or by fixed monitoring stations. Overall, air pollution exposure was associated with a significant reduction (1.41 units) in global DNA methylation (95% C.I. -2.65-0.04, p = 0.026). The decrement in ALU repetitive elements was greatest in the policemen working downtown (95% C.I. -3.23--0.49, p = 0.008). The DNA adducts were found to be significantly increased (0.45 units) in the municipal officers with respect to unexposed subjects (95% C.I. 0.02-0.88, p = 0.039), mainly in those who were controlling traffic in downtown areas (95% C.I. 0.39-1.29, p < 0.001). Regression models indicated an increment of ALU methylation at higher B(a)P concentrations (95% C.I. 0.03-0.60, p = 0.032). Moreover, statistical models showed a decrement in ALU methylation and an increment of DNA damage only above the cut-off value of 30 µg/m3 O3. A significant increment of 0.73 units of IL-6 gene methylation was also found in smokers with respect to non-smokers. Our results highlighted the role of air pollution on epigenetic alterations and genotoxic effects, especially above the target value of 30 µg/m3 surface-level O3, supporting the necessity for developing public health strategies aimed to reduce traffic-related air pollution molecular alterations.

A New Perspective on SPME and SPME Arrow: Formaldehyde Determination by On-Sample Derivatization Coupled with Multiple and Cooling-Assisted Extractions.

Formaldehyde (FA) is a toxic compound and a human carcinogen. Regulating FA-releasing substances in commercial goods is a growing and interesting topic: worldwide production sectors, like food industries, textiles, wood manufacture, and cosmetics, are involved. Thus, there is a need for sensitive, economical, and specific FA monitoring tools. Solid-phase microextraction (SPME), with O-(2,3,4,5,6-pentafluorobenzyl)-hydroxylamine (PFBHA) on-sample derivatization and gas chromatography, is proposed for FA monitoring of real-life samples. This study reports the use of polydimethylsiloxane (PDMS) as a sorbent phase combined with innovative commercial methods, such as multiple SPME (MSPME) and cooling-assisted SPME, for FA determination. Critical steps, such as extraction and sampling, were evaluated in method development. The derivatization was performed at 60 °C for 30 min, followed by 15 min sampling at 10 °C, in three cycles (SPME Arrow) or six cycles (SPME). The sensitivity was satisfactory for the method's purposes (LOD-LOQ at 11-36 ng L-1, and 8-26 ng L-1, for SPME and SPME Arrow, respectively). The method's linearity ranges from the lower LOQ at trace level (ng L-1) to the upper LOQ at 40 mg L-1. The precision range was 5.7-10.2% and 4.8-9.6% and the accuracy was 97.4% and 96.3% for SPME and SPME Arrow, respectively. The cooling MSPME set-up applied to real commercial goods provided results of quality comparable to previously published data.

Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study.

BACKGROUND: Liver transplant recipients require specific clinical and psychosocial attention given their frailty. Main aim of the study was to assess the quality of life after liver transplant during the current pandemic. METHODS: This multicentre study was conducted in clinically stable, liver transplanted patients. Enrollment opened in June and finished in September 2021. Patients completed a survey including lifestyle data, quality of life (Short Form health survey), sport, employment, diet. To examine the correlations, we calculated Pearson coefficients while to compare subgroups, independent samples t-tests and ANOVAs. To detect the predictors of impaired quality of life, we used multivariable logistic regression analysis. RESULTS: We analysed data from 511 patients observing significant associations between quality of life's physical score and both age and adherence to Mediterranean diet (p < .01). A significant negative correlation was observed between mental score and the sedentary activity (p < .05). Female patients scored significantly lower than males in physical and mental score. At multivariate analysis, females were 1.65 times more likely to report impaired physical score than males. Occupation and physical activity presented significant positive relation with quality of life. Adherence to Mediterranean diet was another relevant predictor. Regarding mental score, female patients were 1.78 times more likely to show impaired mental score in comparison with males. Sedentary activity and adherence to Mediterranean diet were further noteworthy predictors. CONCLUSIONS: Females and subjects with sedentary lifestyle or work inactive seem to show the worst quality of life and both physical activity and Mediterranean diet might be helpful to improve it.

Identification of Amoxicillin Crystals in Urine: a Case Report.

BACKGROUND: The case concerns a 30-year-old woman in the 24th week of pregnancy presenting to the medical emergency room with fever and abdominal pain. Urine sediment microscopy revealed the presence of unknown needle-shaped crystals. METHODS: Crystals identification was performed by Fourier-Transform Infrared Spectroscopy coupled to Attenuated Total Reflectance (FTIR-ATR). RESULTS: Amoxicillin crystals were verified with semiquantitative results of 87.7%. CONCLUSIONS: Drug-induced crystalluria is a frequent finding in urine examination and it may be asymptomatic. FTIR spectroscopy is a rapid and specific tool in identification of crystals and could be useful supporting renal disease diagnosis and monitoring drug therapy.

Creation of a database of occupational and environmental concentrations of crystalline silica dust for the purpose of assessing past and current exposures.

BACKGROUND: Professional exposure to respirable dust containing crystalline silica is of great interest for the serious lung diseases resulting from exposure. METHODS: During the period 1986-2019, 3611 exposure data to crystalline silica were collected from companies in central Italy. The data were divided and statistically analyzed based on the sampling system (Cyclone Dorr Oliver, CIP 10-R, Cyclone GS3, SKC plastic selector, Cyclone Higgins-Dewell and Cyclone Lippmann) and the ATECO code (code of economic activity, Italian acronym, used to classify companies when they interface with public institutions) of the companies in which they were collected. For each ATECO code, the division was made according to the type of sampling (personal or static) and the descriptive statistics of the data were calculated. RESULTS: Overall, for personal samples, 8.8% of the data exceeds 0.1 mg/m3, 19.6% exceeds 0.05 mg/m3 and 33.8% exceeds 0.025 mg/m3, the limit values set by the EU Directive 2019/130, suggested by the SCOEL and published by ACGIH respectively. The ATECO codes with the highest worker exposure (geometric means 0.067 and 0.069 mg/m3) were 23.31.00 (manufacture of ceramic tiles for floors and walls) and 23.42.00 (manufacture of ceramic sanitary ware), while the lowest exposure is found in 81.29.91 (cleaning and washing of public areas, removal of snow and ice including shedding of sand) with a geometric mean of 0.002 mg/m3. DISCUSSION: Despite the general reduction over time, there are still many sectors in which data are higher than the current occupational exposure limits; especially in these sectors it is necessary to implement the measures to fully assess worker exposure.

Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers.

INTRODUCTION: In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group. OBJECTIVES: This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers. METHODS: More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated. RESULTS: The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (ß=0.468) and perceptions of supervisor support and social support (ß=0.710). The perception of both parameters is associated with stress outcomes (ß=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001). CONCLUSIONS: The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.

Occupational exposure to airborne formaldehyde in hospital: setting an automatic sampling system, comparing different monitoring methods and applying them to assess exposure.

BACKGROUND: In recent years, under-vacuum sealing (UVS) and containers with formalin encapsulated in the lid have been proposed for the reduction of occupational exposure to airborne formaldehyde (FA) in healthcare environments. OBJECTIVES: We are presenting a study focused on the assessment of FA in hospitals: an automatic sampling system was set, different sampling devices were compared, and the concentration of FA was assessed, following its use in different scenarios. METHODS: Three different devices for sampling/measuring FA were compared. They are based on: 1. silica gel cartridges impregnated with 2,4-dinitrophenylhydrazine (2,4-DNPH); 2. SPME® fiber using O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine; 3. direct reading commercial instrumentation. Three typical scenarios using FA were investigated: operating theatres where small biopsies are soaked into closed-circuit system 4% FA containers, secretariat of pathology laboratories during the registration of biopsies and pathology laboratories during the filling procedure by UVS and the slicing of biopsies. RESULTS: The automatic sampling system allowed short-, long-, and in continuous-sampling time to measure airborne FA. Different sampling devices provided comparable results when tested to assess FA concentration ranging from 0.020-0.320 ppm in a test chamber, although  the devices based on 2,4-DNPH were  the best in terms of sensitivity and accuracy. The results of 246 samples showed that the FA concentration was less than 0.04 ppm in 91% of the measurements. CONCLUSIONS: The automatic methods efficiently allow sampling and measurement of FA in hospital settings. When using safe practices, the concentration of FA is well below occupational limit values.

High-Throughput Analysis of Selected Urinary Hydroxy Polycyclic Aromatic Hydrocarbons by an Innovative Automated Solid-Phase Microextraction.

High-throughput screening of samples is the strategy of choice to detect occupational exposure biomarkers, yet it requires a user-friendly apparatus that gives relatively prompt results while ensuring high degrees of selectivity, precision, accuracy and automation, particularly in the preparation process. Miniaturization has attracted much attention in analytical chemistry and has driven solvent and sample savings as easier automation, the latter thanks to the introduction on the market of the three axis autosampler. In light of the above, this contribution describes a novel user-friendly solid-phase microextraction (SPME) off- and on-line platform coupled with gas chromatography and triple quadrupole-mass spectrometry to determine urinary metabolites of polycyclic aromatic hydrocarbons 1- and 2-hydroxy-naphthalene, 9-hydroxy-phenanthrene, 1-hydroxy-pyrene, 3- and 9-hydroxy-benzoantracene, and 3-hydroxy-benzo[a]pyrene. In this new procedure, chromatography's sensitivity is combined with the user-friendliness of N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide on-fiber SPME derivatization using direct immersion sampling; moreover, specific isotope-labelled internal standards provide quantitative accuracy. The detection limits for the seven OH-PAHs ranged from 0.25 to 4.52 ng/L. Intra-(from 2.5 to 3.0%) and inter-session (from 2.4 to 3.9%) repeatability was also evaluated. This method serves to identify suitable risk-control strategies for occupational hygiene conservation programs.

[Health surveillance programme for workers with past asbestos exposure in Tuscany Region (Central Italy)]. / Il percorso di sorveglianza sanitaria degli ex-esposti ad amianto in Toscana.

Asbestos-related diseases are characterized by a long latency time since exposure. This accounts for a health surveillance programme addressed to asbestos workers to be performed for decades after the cessation of occupational exposure. We describe the health surveillance programme for former asbestos-exposed workers in Tuscany Region (Central Italy), with particular attention to organization and related critical issues. The Deliberation of the Regional Administration of Tuscany (No. 396/2016) supports the programme, defined by a regional group of experts, and defines the public health services where the programme has to be implemented. The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. The former asbestos workers, aged less than 80 years and with cessation of occupational asbestos exposure in the last 30 years, that might be included free of charge in the programme are about 5.600. The funds assigned to develop the programme from 2016 to 2024 were 2,044,808 euros. The Regional Administration of Tuscany decided to offer and guarantee a homogeneous programme in the whole region. The identification of a specific public health programme and the cooperation of social stakeholders, defined with specific regional agreements, might facilitate to overcome the problems which are still open, such as a broaden invitation to adhere to the programme, an extended knowledge on the service, and the application of a similar health programme for still-working former asbestos workers.

Analytical strategies for assessing occupational exposure to antineoplastic drugs in healthcare workplaces.

BACKGROUND: Cytotoxic antineoplastic drugs (ADs), widely used in treating cancer, are considered hazardous in the workplace and thus require safe handling practices. An analytical protocol for environmental and biological AD monitoring in the healthcare environment has been developed, since Europe lacks clear guidelines and regulations for cytostatic preparation and handling. MATERIAL AND METHODS: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used for measuring contemporaneously 20 multi-class cytostatic compounds and urinary α-fluoro-ß-alanine, whereas platinum was detected by inductively coupled plasma mass spectrometry (ICP-MS). Sampling procedures and analytical conditions were optimized and the assays were validated. Environmental AD monitoring data, collected in 2009-2017, for a total of 3749 wipe tests and 57 720 determinations, was evaluated. RESULTS: The proportion of positive samples gradually decreased from 11.7% in 2010 to 1% in 2017, however, 2266 determinations were positive. No urine sample had detectable concentrations of any of the 4 drugs considered (0/398 samples). CONCLUSIONS: These improvements are so large that the key role played by the new, more stringent rules for preparing and administering ADs is evident. Hence, the analytical method involving multi-element determinations allows for a more thorough and complete investigation into the AD contamination of work environments. Med Pr 2018;69(6):589-604.

The New MIRUS System for Short-Term Sedation in Postsurgical ICU Patients.

OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation. INTERVENTIONS: Sevoflurane was administered with the MIRUS system targeted to a Richmond Agitation Sedation Scale from -3 to -5 by adaptation of minimum alveolar concentration. MEASUREMENTS AND MAIN RESULTS: Data collected included Richmond Agitation Sedation Scale, minimum alveolar concentration, inspired and expired sevoflurane fraction, wake-up times, duration of sedation, sevoflurane consumption, respiratory and hemodynamic data, Simplified Acute Physiology Score II, Sepsis-related Organ Failure Assessment, and laboratory data and biomarkers of organ injury. Atmospheric pollution was monitored at different sites: before sevoflurane delivery (baseline) and during sedation with the probe 15 cm up to the MIRUS system (S1) and 15 cm from the filter-Reflector group (S2). Sixty-two patients were enrolled in the study. No technical failure occurred. Median Richmond Agitation Sedation Scale was -4.5 (interquartile range, -5 to -3.6) with sevoflurane delivered at a median minimum alveolar concentration of 0.45% (interquartile range, 0.4-0.53) yielding a mean inspiratory and expiratory concentrations of 0.79% (SD, 0.24) and 0.76% (SD, 0.18), respectively. Median awakening time was 4 minutes (2.2-5 min). Median duration of sevoflurane administration was 3.33 hours (2.33-5.75 hr), range 1-19 hours with a mean consumption of 7.89 mL/hr (SD, 2.99). Hemodynamics remained stable over the study period, and no laboratory data indicated liver or kidney injury or dysfunction. Median sevoflurane room air concentration was 0.10 parts per million (interquartile range, 0.07-0.15), 0.17 parts per million (interquartile range, 0.14-0.27), and 0.15 parts per million (interquartile range, 0.07-0.19) at baseline, S1, and S2, respectively. CONCLUSIONS: The MIRUS system is a promising and safe alternative for short-term sedation with sevoflurane of ICU patients. Atmospheric pollution is largely below the recommended thresholds (< 5 parts per million). Studies extended to more heterogeneous population of patients undergoing longer duration of sedation are needed to confirm these observations.

Occupational exposure to nitrous oxide during procedural pain control in children: a comparison of different inhalation techniques and scavenging systems.

BACKGROUND: Nitrous oxide (N2 O 50% in oxygen) is commonly used for painful procedures in children. Potential negative health effects associated with chronic workplace exposure limit its use. Safe occupational N2 O exposure concentrations are below 25 ppm environmental concentration as a time-weighted average (TWA) and below 200 ppm as a short-time exposure level (STEL) of 15 min. AIM: The aim was to assess occupational exposure of staff during nitrous oxide administration to children using different inhalation delivery devices and scavenging systems. METHODS: Staff nitrous oxide exposure during use of a double face mask (DFM) with or without a demand valve (DV) was compared with a conventional single face mask (FM). We also compared exposure using the hospital central scavenging system with a portable evacuation system. N2 O concentrations, representing exposure values, were monitored within proximity to staff. Urine N2 O concentration was measured in staff administering the N2 O at the end of the procedural session. RESULTS: The mean and median values of TWA and STEL within the working area were lower than recommended values in the DFM (10.8, 11.6 ppm for TWA; 13.9, 11.0 ppm for STEL) and DFM-DV groups (2.3, 2.8 ppm for TWA; 4.4, 3.5 ppm for STEL) using the portable evacuation system. The N2 O urine exposure in DFM-DV group was lower than DFM group: a mean difference of 9.56 ppm (95% CI 2.65-16.46). Staff N2 O urinary concentrations were within safe biological limits in both the DFM and DFM-DV groups. High exposure concentrations to N2 O were recorded in all FM and FM-DV environmental and biological samples. CONCLUSIONS: The DFM system, with or without a DV, connected to a portable evacuation system during N2 O administration to children for painful procedures kept N2 O levels within the local environment below recommended limits.

Bullying among nurses and its relationship with burnout and organizational climate.

Workplace bullying is one of the most common work-related psychological problems. Bullying costs seem higher for organizations composed of health-care workers who perform direct-contact patients-complex tasks. Only a few studies have been carried out among nurses in Italy and integrated models of bullying antecedents and consequences are particularly missing. The aim of this study was to develop a bullying model focused on the interaction between bullying and burnout in the setting of a climate-health relationship. Research involved 658 nurses who completed a survey on health, burnout, bullying and organizational climate. Structural equation modeling was used to test the hypothesis. Results suggest that workplace bullying partially mediates the relationship between organizational climate and burnout and that bullying does not affect health directly, but only indirectly, via the mediation of burnout. Our study demonstrates the key-role of workplace bullying and burnout in the climate-health relationship in order to understand and to improve nurses' health.

[Prevalence of workplace bullying in a population of nurses at three Italian hospitals]. / Prevalenza del fenomeno mobbing in una popolazione di infermieri di tre aziende ospedaliere italiane.

Negative behaviors could be considered as a risk index of workplace bullying; researching on these events is useful for the planning of preventive interventions. The aim of this study was to investigate the prevalence of negative actions in a population of nurses and their possible association with issues related to mental health. We administered a proper questionnaire, based both on the NAQ-R and on the GHQ12, to 206 subjects, who worked in three hospitals, located in the center and south of Italy. Our results confirmed that the nursing profession presents a clear bullying risk in the workplace, without any notable differences regarding gender or demographics. The prevalence of negative actions was noteworthy, mainly with regard to the job position and the task. Our study also showed that workplace bullying may interfere with the overall health of nurses, particularly connected to psycho-emotional issues.

Adherence to Mediterranean diet in liver transplant recipients: a cross-sectional multicenter study.

BACKGROUND: Seeing the importance of healthy diet after liver transplant (LT), our study aimed to evaluate the adherence to Mediterranean diet (MD) in a large population of LT recipients. METHODS: The present multicenter study was developed in clinically stable, liver transplanted patients, from June to September 2021. Patients completed a survey about adherence to MD, Quality of Life (QoL), sport, and employment. To analyze the correlations, we computed Pearson's coefficients; while to compare subgroups, independent samples t-tests and ANOVAs. We used a multivariable logistic regression analysis to find the predictors of impaired adherence to MD. RESULTS: The questionnaire was administered to 511 patients. They were males in 71% of cases with a mean age of 63.1 years (SD±10.8). LT recipients coming from central Italy displayed higher adherence to the MD (M=11.10±1.91) than patients from northern (M=9.94±2.28, P<0.001) or southern Italy (M=10.04±2.16, P<0.001). Patients from central Italy showed a significantly higher consumption of fruit, vegetables, legumes, cereals, olive oil, fish and a significantly lower intake of dairy products than patients resident in the other Italian areas. At multivariate analysis, recipients from central Italy were 3.8 times more likely to report adherence to the MD. Patients with a high physical health score were more adherent to MD, as well as patients transplanted at an earlier time. CONCLUSIONS: We demonstrated that place of stay, time from transplant and physical dimension of QoL significantly influences the adherence to MD. Continuous information campaigns about a correct diet and lifestyle would be necessary.

Simultaneous Determination by Selective Esterification of Trimellitic, Phthalic, and Maleic Anhydrides in the Presence of Respective Acids.

Trimellitic, phthalic, and maleic anhydrides are important building blocks to produce polymers and additives, such as plasticizers. In humans, the exposure to these compounds can cause several health issues. In European Union and USA, their presence in substances and mixtures is restricted by CLP Regulation (no. 1272/2008) and HCS/HazCom 2012, respectively, but no information about the corresponding acids is reported. For this reason, a selective method to determine anhydrides in mixtures, in the presence of acids, could be interesting. Nowadays, methods in the literature are either not selective or use explosive and toxic reagents (as diazomethane). In this work, an innovative, greener, and safer method for the simultaneous recognition and quantification of anhydrides and acids, via direct injection gas chromatography-mass spectrometry, is developed. The sample pretreatment consists in selective esterification with absolute ethanol on the anhydride, followed by a treatment with boron trifluoride-methanol for the methylation of remaining carboxylic groups. The optimization of the functionalization, a crucial step of the method, was optimized by experimental design. The limit of detection-limit of quantification (LOD-LOQ) values for trimellitic, phthalic, and maleic anhydrides are 0.31-0.93, 0.47-1.41, and 0.06-0.18 µg/mL, respectively.

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I - medical gloves.

Antineoplastic drugs (ADs) are essential tools in cancer treatment, but their cytotoxicity poses a risk to workers involved in their handling. In a hospital environment fundamental strategies for minimising exposure involve proper use of safety cabinets and closed-circuit transfer devices, along with personnel training and increased awareness of risks. However, medical gloves remain the first line of defence. In this respect the evaluation of glove materials and best choices can improve hospital safety management and prevent potential hazards and long-term consequences. The aim of this study was to assess contamination of gloves in samples taken from AD administration and preparation units of nine Italian hospitals and to raise awareness of the importance of evaluating chemico-physical properties of gloves. Our findings show that 33 % of the analysed gloves were positive for at least one AD, with contaminations ranging from 0.6 to 20,729 pg/ cm2. We proposed the alert glove values (AGVs) for each AD as a limit value for contamination assessment and good practice evaluation. Our findings also point to multiple AD contamination (43 % of positive findings in preparation units), calculated as total AGV (AGV-T), and confirm that gloves should be replaced after 30 min of AD handling, based on cumulative permeation and area under the curve (AUC), to maintain safety and limit dermal exposure.

Physical Impact of SARS-CoV-2 Infection in a Population of Italian Healthcare Workers.

SARS-CoV-2 infection often causes symptoms and illness that can last for months after the acute phase, i.e., so-called "Long COVID" or Post-acute COVID-19. Due to the high prevalence of SARS-CoV-2 infection among Healthcare Workers (HCWs), post-COVID-19 symptoms can be common and threaten workers' occupational health and healthcare systems' functioning. The aim of this cross-sectional, observational study was to present data related to post-COVID-19 outcomes in a population of HCWs infected by COVID-19 from October 2020 to April 2021, and to identify possible factors associated with the persistence of illness, such as gender, age, previous medical conditions, and features of acute illness. A total of 318 HCWs who had become infected by COVID-19 were examined and interviewed approximately two months after their recovery from the infection. The clinical examinations were performed by Occupational Physicians in accordance with a specific protocol at the Occupational Medicine Unit of a tertiary hospital in Italy. The mean age of the participants was 45 years old, and 66.7% of the workers were women while 33.3% were men; the sample mainly consisted of nurses (44.7%). During the medical examination, more than half of the workers mentioned that they had experienced multiple residual bouts of illness after the acute phase of infection. Men and women were similarly affected. The most reported symptom was fatigue (32.1%), followed by musculoskeletal pain (13.6%) and dyspnea (13.2%). In the multivariate analysis, dyspnea (p < 0.001) and fatigue (p < 0.001) during the acute stage of illness and the presence of any limitation in working activities, in the context of fitness for a work evaluation performed while the occupational medicine surveillance program was being conducted (p = 0.025), were independently associated with any post-COVID-19 symptoms, which were considered final outcomes. The main post-COVID-19 symptoms-dyspnea, fatigue, and musculoskeletal pain-showed significant associations with dyspnea, fatigue, and musculoskeletal pain experienced during the acute stage of infection, with the presence of limitations in working activities, and pre-existing pneumological diseases. A normal weight according to body mass index was a protective factor. The identification of vulnerable workers as those with limitations in working activities, pneumological diseases, a high BMI, and of an older age and the implementation of preventive measures are key factors for preserving Occupational Health. Fitness-to-work evaluations performed by Occupational Physicians can be considered a complex index of overall health and functionality that can identify workers who may suffer from relevant post-COVID-19 symptoms.

Prevention, Risk Exposure, and Knowledge of Monkeypox in Occupational Settings: A Scoping Review.

With ongoing climate change, which alters the conditions for pathogens and vectors, zoonotic diseases such as monkeypox virus will become a challenge and a great threat impacting global health in future decades. A current outbreak of monkeypox is occurring in over 125 countries, with a report of thousands of cases in countries where this virus has never appeared. Occupational exposure to the monkeypox virus has recently been identified as an issue of major concern for occupational health, especially in healthcare settings. A scoping review following the PRISMA guidelines was performed, aiming to analyze the effects that the current monkeypox outbreak has in workplaces, given the potential exposure of healthcare workers to the virus, the possible spread of the virus in occupational settings, and the preventive measures that are necessary to implement. At the end of the selection process, 21 studies were included in the review. Healthcare workers are considered at a high risk, and similar preventive measures to those adopted during the SARS-CoV-2 pandemic must be implemented in all healthcare settings. The main recommendations for preventing and managing monkeypox in occupational settings are the vaccination of exposed workers, the prompt identification and isolation of infected individuals, and good hygiene practices. Education and specific training are necessary in non-endemic countries to make healthcare workers able to recognize the disease and prevent further contagions. Although monkeypox seems unlikely to reach the pandemic spread of COVID-19, an approach to global health even to avoid future zoonotic epidemics is required by all stakeholders.

Advanced Solid-Phase Microextraction Techniques and Related Automation: A Review of Commercially Available Technologies.

The solid-phase microextraction (SPME), invented by Pawliszyn in 1989, today has a renewed and growing use and interest in the scientific community with fourteen techniques currently available on the market. The miniaturization of traditional sample preparation devices fulfills the new request of an environmental friendly analytical chemistry. The recent upswing of these solid-phase microextraction technologies has brought new availability and range of robotic automation. The microextraction solutions propose today on the market can cover a wide variety of analytical fields and applications. This review reports on the state-of-the-art innovative solid-phase microextraction techniques, especially those used for chromatographic separation and mass-spectrometric detection, given the recent improvements in availability and range of automation techniques. The progressively implemented solid-phase microextraction techniques and related automated commercially available devices are classified and described to offer a valuable tool to summarize their potential combinations to face all the laboratories requirements in terms of analytical applications, robustness, sensitivity, and throughput.